Evaluate correlation of duodenogastric reflux detected on Tc-99m mebrofenin hepatobiliary scintigraphy with gastroesophageal reflux disease: A retrospective study.

52 Objectives GERD is thought to result primarily from gastric acid reflux. Recent literature suggests that symptomatic GERD also occurs from duodenogastric reflux of bile acids. This has been termed alkaline variant GERD and appears to be more damaging to the esophagus and has a more symptomatic clinical course. We aim to evaluate whether the presence of duodenogastric reflux (DGR) seen on Tc-99m mebrofenin hepatobiliary scintigraphy (MHBS) correlates with presence of clinical GERD and whether degree of DGR seen correlates with clinical severity of GERD. Methods 300 Tc-99m MHBS exams conducted from January 2011-December 2014 were included in this study and were evaluated for presence of DGR. Patients’ chart were reviewed to identify for clinical diagnosis of GERD and the severity of GERD that was determined using clinical data points including endoscopic evaluation of GERD, oral medications for treatment of GERD and presence/absence Barrett’s esophagus, etc. Results 83 patients (45 females and 38 males) with mean age 47.9 (range: 13 - 93 years old) were identified to have evidence of DGR. Of these patients, 31.3% patients were diagnosed with cholecystitis and 7.2% patients were diagnosed with biliary colic. 25.3% patients had only clinical history of GERD and no additional significant history. Of the patients with clinical evidence of GERD, 42.9% patients had evidence of severe DGR, 38.1% had moderate DGR and 19% had mild DGR noted. 4.7% patients with GERD and severe DGR had histopathologic evidence of Barrett9s esophagus. Conclusions DGR is easily detected and frequently identified on Tc-99m MHBS and a significant proportion patients with scintigraphic evidence of DGR have GERD. As emerging literature is demonstrating stronger correlation between bile acid reflux and symptomatic GERD, DGR is an important diagnostic consideration as the cause of patients presenting symptoms in an otherwise normal HIDA study. Research Support This is a not a funded study and none of the authors have any relevant disclosures.